1174582365 NPI number — DR. JANET D TUCKER D.C.

Table of content: DR. JANET D TUCKER D.C. (NPI 1174582365)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174582365 NPI number — DR. JANET D TUCKER D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TUCKER
Provider First Name:
JANET
Provider Middle Name:
D
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RAMAGE
Provider Other First Name:
JANET
Provider Other Middle Name:
D
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
D.C.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1174582365
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/28/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 103
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OGDEN
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66517-0103
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
785-223-3388
Provider Business Mailing Address Fax Number:
785-537-2636

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
526 RILEY AVE.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OGDEN
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66517-0103
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-223-3388
Provider Business Practice Location Address Fax Number:
785-537-2636
Provider Enumeration Date:
03/17/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  01-04535 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)